'Polypill' reduces risk for heart attack, stroke by up to 40%, study finds

Nov. 13 (UPI) -- A so-called "polypill" that combines three blood pressure medications and a cholesterol-lowering drug, when taken with aspirin, reduces risk for heart attack or stroke by up to 40%, according to a study published Friday by the New England Journal of Medicine.

Taken alone, the combination drug -- which is not available in the United States -- lowers a person's risk for heart attack or stroke, as well as the need for angioplasty or other types of heart surgery, by 20%, the data showed.

When administered with aspirin -- with its proven ability to prevent heart attacks by stopping blood clots -- the combination works to decrease the risk for these cardiovascular events by twice as much as without it, the researchers said.

"Studies of polypills, now including ours, have shown that they reduce risk by 30% to 40%," study co-author Dr. Salim Yusuf told UPI.

"We hope our findings add to the momentum created by other similar studies and push drug manufacturers to make these products available in North America," said Yusuf, a professor of medicine at McMaster University in Canada.

Currently, polypill therapies have been approved and are available for use in Europe and South America, as well as in parts of Asia and Africa, according to Yussef.

U.S.-based drug manufacturers have yet to initiate clinical trials of similar products, despite the positive findings, he said.

Although the formulation of polypills varies from country to country, the product used in this study contained 40 milligrams of simvastatin, 100 mg. of atenolol, 25 mg. of hydrochlorothiazide and 10 mg. of ramipril, according to the researchers.

Simvastatin, also sold under the brand name Zocor, is used to treat high cholesterol, while atenolol, hydrochlorothiazide and rampiril are all blood pressure medications.

Heart disease causes roughly 18 million deaths each year, and more than 40 million people around the world have heart attacks or strokes annually, based on World Health Organization estimates.

In the United States, about 18.2 million adults age 20 and older have heart disease, according to the Centers for Disease Control and Prevention.

The new study was conducted in 89 centers in nine countries and coordinated by the Population Health Research Institute at McMaster University and Hamilton Health Sciences.

For the study, Yusuf and his colleagues assessed the effects of the polypill alone or in combination with aspirin in 5,714 men aged 50 years and older and women aged 55 years and older.

Those who took the polypill with aspirin used a low dose of 75 mg. per day for the aspirin.

After following study participants for an average of about five years, the researchers found that 4.4% of those who took the polypill alone had a heart attack, stroke, heart procedure or died from heart-related causes, compared with 5.5% of those given a placebo.

Of those who took only aspirin, 4.1% suffered these heart-related events, according to the researchers. Similarly, about 4.1% of those who took the polypill with aspirin experienced heart complications, the data showed.

The chief benefit of the polypill, in addition to its effectiveness, is convenience, as it means those for whom treatment is needed will have to take only one pill daily, instead of three or four, Yusuf said.

This should improve compliance with prescribed treatments, he added.

"In addition to stopping smoking, the most modifiable risk factors for cardiovascular disease are high blood pressure and elevated cholesterol," Yusuf said.